Individual
KIMBERLY A. DURETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5891
(401) 444-8158
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00667
RI
363A00000X
Physician Assistant
PA4565
MA
Other
Enumeration date
07/23/2010
Last updated
09/13/2021
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